Nursing intervention with rationale:
1. Perform routine comprehensive pain assessment, including location, characteristics, onset, duration, frequency, quality, and severity using some type of rating scale, such as numbers or visual analog, facial expressions, or color scale.
Rationale: Assessment of children involves observational skills and may require enlisting the aid of parent or caregiver to clarify cues and verbalizations. Choice of rating scale is dependent on age and developmental level (Suresh, 2002).

2. Accept child’s description of pain, noting precipitating, exacerbating, and relieving factors.
Rationale: Pain is subjective and cannot be experienced by others. Note: In presence of chronic pain situation, use of a pain diary may be appropriate for adolescents (Suresh, 2002).

3. Investigate changes in frequency or description of pain.
Rationale: May signal worsening of condition or development of complications.

4. Observe for guarding, rigidity, crying, and restlessness.
Rationale: Nonverbal expressions, body movement, and behavioral state may signal pain or changes in pain severity, especially in infants and younger children (Suresh, 2002).

7. Identify ways to avoid or minimize pain, such as splinting surgical incisions during coughing, sleeping on a firm mattress, or wearing brace on sprains.
Rationale: Many factors may reduce pain intensity based on specific situation. Child can quickly learn and use such pain management techniques, enhancing sense of control as well as comfort.

8. Review procedures and expectations and tell child when it will hurt. Provide distraction during painful procedures, such as deep breathing or counting, or looking at something that interests child.
Rationale: Although the procedure may still be stressful, child will find it easier to handle if he or she knows what to expect and has developed coping strategies.

10. Administer medications, such as opioid and nonsteroidal analgesics, as indicated. Use multiple routes to deliver analgesia, such as oral, nebulized, transdermal, or patientcontrolled analgesia (PCA), as indicated by current situation.
Rationale: Depending on the cause and type of pain, as well as its chronicity, various means of pain management may be needed to overcome or control pain.